Fluency Scores Research Articles

Abstract MP63: Longitudinal Analysis Of Handgrip Strength And Cognitive Function During Aging- Share

Background: Aging is associated with various chronic conditions, such as cognitive and muscle strength decline. Previous studies have analysed the association between physical factors and cognitive decline however, the magnitude and the direction of the association between handgrip strength (HGS) and cognitive decline are not fully understood. Objectives: To analyse the association between HGS and cognitive decline in numeracy, recall and verbal fluency according to sex in a large multicentric population. Methods: A longitudinal study including people aged 50 and over from the Survey of Health, Aging and Retirement in Europe (SHARE) was conducted, involving participants from 28 European countries. Repeated HGS measures from a dynamometer and cognitive scores in numeracy, recall, and verbal fluency were biannually analysed for 4 years. Individuals with Parkinson along the study or dementia diagnosis at baseline were excluded. For the analysis of HGS as a predictor of future cognitive decline, HGS was categorized in quintiles by sex. In men HGS quintiles were Q1 (8-35kg), Q2 (36-41kg), Q3 (42-45kg), Q4 (46-50kg) and Q5 (51-80kg). In women HGS quintiles were Q1 (4-21kg), Q2 (22-25 kg), Q3 (26-28 kg), Q4 (29-32 kg) and Q5 (33-55 kg). First quintile in each sex was used as reference. In the analysis of cognitive performance as a predictor of HGS decline, different cognitive scores were treated in their logarithmical form as a function of HGS continuously. Possible confounding factors were controlled through general estimated equations and adjusted for baseline handgrip strength quintile and time-varying covariates as age, time, education, smoking status, alcohol consumption, physical activity, BMI index, chronical illnesses, Alzheimer disease, depression, functionality scores, and sarcopenia. Results: A total of 8,236 individuals were included, 55.73% were females with a mean age of 67.55 (± 8.4) years, while in males it was of 68.42 (±7.7) years. A significant longitudinal association between HGS and cognitive function in all three domains was found in both sexes, except numeracy in males. The fully adjusted β coefficients CI (95%) for the fifth HGS quintile in numeracy, verbal fluency and recall were 0.041 (0.004-0.082), 0.078 (0.038-0.117) and 0.095 (0.039-0.151) respectively for men and 0.076 (0.039-0.113), 0.094 (0.060-0.0128) and 0.092 (0.047-0.137) respectively for women. On the other hand the greatest cognitive predictor of HGS was verbal fluency in both sexes, β(95%), 0.796 (0.464 to 1.128)kg in men and 0.801 (0.567 to 1.109)kg in women. Conclusion: There is a significant and bidirectional association between HGS and the cognitive performance in men and women over 50 years studied in SHARE.

An Analysis on Students’ Speaking Ability of Procedure Text at Senior High School

This research discusses the students’ speaking ability of Procedure Text at the Second Grade Students of SMA Tri Bhakti Pekanbaru. The objective of the research is to know the students’ speaking ability in procedure text and to find out which aspectt is the most dominant problem for the students in speaking. The design of this research was qualitative research. The result of data was students’ comprehension score was 3.15 because most of them understood the directions on the speaking test well and they also conveyed the procedure text sequentially using the simple present tense correctly so that the listener could understand them although there were several problems. Students’ fluency score was 3.15 because most of the students’ present the procedure text fluently and smoothly even though some students stammered and paused several times. Students’ grammar score was 3.13 because most of them were good at arranging their sentences correctly according to the grammar rules using the simple present tense even though they made some mistakes. The students' pronunciation score was 2.86 because some students had difficulty in pronouncing some words and there were some confusions with the listener, although not all students did so. Students’ vocabulary score was 2.92 because some students had problem with vocabulary mastery and use inappropriate vocabulary, but overall the students have sufficient vocabulary to express tips simply related to the topic. In conclusion, the students' speaking ability on procedure text is in a good category.

The effect of SFL-based genre instruction on Iranian EFL learners’ performance in story reproduction

AbstractThis study aimed at investigating the effect of SFL-based genre instruction on Iranian EFL learners’ performance in story reproduction. For this purpose, the researcher selected 38 EFL learners through administration of Oxford Placement Test (OPT) and assigned them into experimental and control groups and both groups took an oral reproduction pre-test. Then, in the control group, only common class procedures such as pair work, small-group discussion, and whole class discussion were applied whereas in the experimental group, SFL-based genre analysis of the short stories was conducted by the teacher. At the end of the study, both groups took the post-test. The results of the study revealed a higher amount of increase in the fluency and accuracy scores of the participants in the experimental group in comparison to the control group. The findings of the present study can be advantageous for teachers, syllabus designers, curriculum developers, and Ministry of Education in developing genre-based course for language learners.

Using Automatic Speech Recognition to Assess Thai Speech Language Fluency in the Montreal Cognitive Assessment (MoCA).

The Montreal cognitive assessment (MoCA), a widely accepted screening tool for identifying patients with mild cognitive impairment (MCI), includes a language fluency test of verbal functioning; its scores are based on the number of unique correct words produced by the test taker. However, it is possible that unique words may be counted differently for various languages. This study focuses on Thai as a language that differs from English in terms of word combinations. We applied various automatic speech recognition (ASR) techniques to develop an assisted scoring system for the MoCA language fluency test with Thai language support. This was a challenge because Thai is a low-resource language for which domain-specific data are not publicly available, especially speech data from patients with MCIs. Furthermore, the great variety of pronunciation, intonation, tone, and accent of the patients, all of which might differ from healthy controls, bring more complexity to the model. We propose a hybrid time delay neural network hidden Markov model (TDNN-HMM) architecture for acoustic model training to create our ASR system that is robust to environmental noise and to the variation of voice quality impacted by MCI. The LOTUS Thai speech corpus was incorporated into the training set to improve the model’s generalization. A preprocessing algorithm was implemented to reduce the background noise and improve the overall data quality before feeding data into the TDNN-HMM system for automatic word detection and language fluency score calculation. The results show that the TDNN-HMM model in combination with data augmentation using lattice-free maximum mutual information (LF-MMI) objective function provides a word error rate (WER) of 30.77%. To our knowledge, this is the first study to develop an ASR with Thai language support to automate the scoring system of MoCA’s language fluency assessment.

Associations of Neurocognition and Social Cognition With Brain Structure and Function in Early-Onset Schizophrenia.

BackgroundCognitive impairment is a core feature of schizophrenia that is more serious in patients with early-onset schizophrenia (EOS). However, the neuroimaging basis of cognitive functions, including neurocognition and social cognition, remains unclear in patients with EOS.MethodsForty-three patients with EOS underwent structural and resting state functional magnetic resonance imaging scans. Brain structure and function were evaluated through the analysis of brain gray matter volume (GMV) and amplitude of low-frequency fluctuations (ALFF). They underwent comprehensive assessments for neurocognition (verbal memory, verbal expression, attention, and executive function) and social cognition (theory of mind and attributional bias). Correlation analyses were conducted to detect the potential link between cognitive function indices and brain imaging parameters.ResultsFirst, neurocognition was linked to brain structure characterized by higher immediate recall scores associated with increased GMV in the left temporal pole, higher verbal fluency scores associated with increased GMV in the left temporal pole: middle temporal gyrus, and higher Stroop-word scores associated with increased GMV in the right middle frontal gyrus. Second, social cognition was related to brain function characterized by lower sense of reality scores associated with increased ALFF in the left precentral gyrus, higher scores of accidental hostility bias associated with increased ALFF in the right middle temporal gyrus, and higher scores of accidental aggression bias associated with increased ALFF in the left precentral gyrus.ConclusionThese findings may add to the existing knowledge about the cognitive function-brain relationship. They may have clinical significance for studying the mechanism of neurocognitive and social cognitive impairment in patients with EOS and providing potential neural targets for their treatment and intervention.

The long-term effects of a polygenetic predisposition to general cognition on healthy cognitive ageing: evidence from the English Longitudinal Study of Ageing.

As an accelerated cognitive decline frequently heralds onset of severe neuropathological disorders, understanding the source of individual differences in withstanding the onslaught of cognitive ageing may highlight how best cognitive abilities may be retained into advanced age. Using a population representative sample of 5088 adults aged •50 years from the English Longitudinal Study of Ageing, we investigated relationships of polygenic predisposition to general cognition with a rate of change in cognition during a 10-year follow-up period. Polygenic predisposition was measured with polygenic scores for general cognition (GC-PGS). Cognition was measured employing tests for verbal memory and semantic fluency. The average baseline memory score was 11.1 (s.d. = 2.9) and executive function score was 21.5 (s.d. = 5.8). An increase in GC-PGS by one standard deviation (1-s.d.) was associated with a higher baseline verbal memory by an average 0.27 points (95% CI 0.19-0.34, p < 0.001). Similarly, 1-s.d. increase in GC-PGS was associated with a higher semantic fluency score at baseline in the entire sample (β = 0.45, 95% CI 0.27-0.64, p < 0.001). These associations were significant for women and men, and all age groups. Nonetheless, 1-s.d. increase in GC-PGS was not associated with decreases in verbal memory nor semantic fluency during follow-up in the entire sample, as well stratified models by sex and age. Although common genetic variants associated with general cognition additively are associated with a stable surplus to cognition in adults, a polygenic predisposition to general cognition is not associated with age-related cognitive decline during a 10-year follow-up.

Improving Mood and Cognitive Symptoms in Huntington's Disease With Cariprazine Treatment.

In Huntington's disease (HD), the main clinical symptoms include depression, apathy, cognitive deficits, motor deficiencies and involuntary movements. Cognitive, mood and behavioral changes may precede motor symptoms by up to 15 years. The treatment of these diverse symptoms is challenging. Tetrabenazine and deutetrabenazine are the only medications specifically approved for Huntington's chorea, but they do not affect the non-motor symptoms. For these, antidepressants, antipsychotics, and benzodiazepines have demonstrated benefit in some cases and can be used off-label. These drugs, due to sedative side effects, may negatively influence cognition. Sixteen patients having HD received a 12-week off-label cariprazine (CAR) treatment (1.5–3 mg/day). Cognitive performance and behavioral changes were measured by the Addenbrooke Cognitive Examination (ACE) test, the Cognitive and Behavioral part of the Unified Huntington's Disease Rating Scale (UHDRS), and the Beck Depression Inventory (BDI). Mixed model for repeated measures was fitted to the data, with terms of visit, baseline (BL) and their interaction. Cariprazine treatment resulted in the following changes from BL to week 12, respectively: the mean score of BDI decreased from 17.7 ± 10.7 to 10.0 ± 10.7 (p <0.0097), while the Behavioral Assessment score of the UHDRS decreased from 54.9 ± 11.3 to 32.5 ± 15.4 (p < 0.0001); ACE score increased from 75.1 ± 11.0 to 89.0 ± 9.3 (p < 0.0001); Cognitive Verbal Fluency score from 6.2 ± 2.5 to 7.7 ± 2.7 (p < 0.0103); Symbol Digit Test from 9.2 ± 6.9 to 12.3 ± 8.9 (p < 0.0009). Mild akathisia was the most frequent side effect, presenting in 2 out of 16 patients (12.5%). We conclude that CAR had a positive effect on depressive mood, apathy and cognitive functions in patients with early stage of HD. Based on the neurobiological basis of these symptoms, CAR can improve the dopamine imbalance of the prefrontal cortex. This draws attention to the transdiagnostic approach which supports the further understanding of the similar symptomatology of different neuropsychiatric disorders and helps to identify new indications of pharmaceutical compounds.

Mid-Life Physical Activity and Late-Life Cognitive Performance among American Indians

Introduction: Research on factors associated with late-life cognitive performance in diverse racial/ethnic groups is increasingly important due to the growing size and racial diversity of the elder population. Methods: Using data on American Indians (AIs) from the Strong Heart Study, we measured associations between mid-life physical activity (PA), assessed by a questionnaire or pedometer, and performance on tests of general cognitive function, phonemic fluency, verbal learning and memory, and processing speed. Cognitive tests were administered 7–21 years after PA measurements. To estimate associations, we used regression models with and without inverse-probability weights to account for potential attrition bias in the cohort. Results: Questionnaire and pedometer measures of PA were positively associated with cognitive function. Participants in the top quartile of questionnaire-based PA had Modified Mini-Mental State examination scores 3.2 (95% CI: 1.5–4.9) points higher than participants in the lowest quartile. Phonemic fluency scores also trended higher for participants in the top compared to the bottom categories for both PA measures: top questionnaire quartile = 2.7 (95% CI: 0.6–4.8) points higher and top pedometry tertile = 6.7 (95% CI: 2.7–10.7) points higher. We observed no associations between PA and tests assessing verbal learning and memory, or processing speed. Weighted model results were similar, but less precise. Conclusions: In this cohort of AIs with relatively low levels of PA, positive associations between mid-life PA and late-life cognitive performance were dose-dependent and of modest clinical significance.

Association between blood metals mixtures concentrations and cognitive performance, and effect modification by diet in older US adults.

Background:Chronic exposure to heavy metals has been associated with adverse neurological outcomes in older adults. Inflammatory processes are suspected as an underlying pathway by which metals exert their neurotoxicity. In parallel, a diet rich in antioxidant and anti-inflammatory components may protect against chronic inflammation.Objectives:We examined the associations of blood concentrations of lead, cadmium, and manganese as a mixture with cognitive performance in older US adults and potential modification of these associations by diet as measured by the Healthy Eating Index 2015 (HEI-2015) and the Adapted Dietary Inflammatory Index (ADII).Methods:We used data on 1,777 adults ≥60 years old from the US National Health and Nutrition Examination Survey (NHANES; 2011–2014). We derived the ADII and the HEI-2015 from two nonconsecutive 24-hour diet recalls. Cognitive performance was measured by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning subtest, the animal fluency test, and the Digit Symbol Substitution Test (DSST). We also constructed a composite z-score reflecting overall cognitive performance. We used quantile g-computation to evaluate the joint associations of a mixture of metals with cognitive performance test scores. We also evaluated effect modification by sex and diet quality indices using Cochran Q tests.Results:The median (interquartile range) of blood metals were 0.38 μg/L (0.35), 14.70 μg/L (11.70), and 8.74 μg/L (4.06) for cadmium, lead, and manganese, respectively. Increasing blood concentrations of all metals by one quartile was associated with a decrease in overall cognitive performance (–0.04; 95% confidence interval [CI] = –0.09, 0.02), CERAD (–0.04; 95% CI = –0.12, 0.03), animal fluency (–0.02; 95% CI, –0.11, 0.06), and DSST (–0.05; 95% CI = –0.11, 0.02) test scores. These associations were more pronounced in adults with high pro-inflammatory or low-diet quality and null or positive though imprecise associations in participants with a high anti-inflammatory. These associations also varied by sex with inverse associations in men and positive associations in women.Conclusions:Our findings suggest that adherence to an antioxidant and anti-inflammatory diet may prevent blood metals adverse cognitive effects among older adults. If confirmed, strategies based on diet could provide a potential complementary and efficient approach to counteract effects of environmental pollutants.

Sleep alterations are related to cognitive symptoms in Parkinson's disease: A 24-hour ambulatory polygraphic EEG study

BackgroundSleep disorders are frequent and early non-motor symptoms of Parkinson's disease (PD). As a consequence of histopathological changes, the regulation of rapid eye movement (REM) sleep is affected in PD causing REM sleep behaviour disorder in about half of the patients. Considering the well-known role of sleep in memory formation processes, our aim was to investigate the relationship between sleep alterations and cognitive performance to elucidate the possible association between sleep, and especially REM sleep changes and cognitive dysfunction in PD. MethodsWe investigated 25 PD patients and 20 healthy controls. All participants underwent a 24-hour-long 19-channel polygraphic EEG recording, neurological, neuroimaging and neuropsychological examination. The visually analysed sleep-EEG and neuropsychological data were statistically evaluated. ResultsThe intergroup analysis showed significant decrease of REM and N3, but increase of N2 sleep ratio, and significantly lower scores in the verbal fluency in PD compared to healthy controls. While we found significant negative correlation between verbal fluency and REM-sleep in the whole sample, we observed a marginal significant correlation between phonemic fluency and REM sleep in the PD group. ConclusionThe negative correlation between verbal fluency performance and REM sleep duration suggests the role of decreased REM sleep in cognitive dysfunction in PD. The early involvement of REM sleep regulation with parallel executive dysfunction in PD emphasise the important role of REM sleep deterioration in the neurodegenerative process of PD.

Semantic and phonetic similarity of verbal fluency responses in early-stage psychosis

Linguistic abnormalities can emerge early in the course of psychotic illness. Computational tools that quantify similarity of responses in standardized language-based tasks such as the verbal fluency test could efficiently characterize the nature and functional correlates of these disturbances. Participants with early-stage psychosis (n=20) and demographically matched controls without a psychiatric diagnosis (n=20) performed category and letter verbal fluency. Semantic similarity was measured via predicted context co-occurrence in a large text corpus using Word2Vec. Phonetic similarity was measured via edit distance using the VFClust tool. Responses were designated as clusters (related items) or switches (transitions to less related items) using similarity-based thresholds. Results revealed that participants with early-stage psychosis compared to controls had lower fluency scores, lower cluster-related semantic similarity, and fewer switches; mean cluster size and phonetic similarity did not differ by group. Lower fluency semantic similarity was correlated with greater speech disorganization (Communication Disturbances Index), although more strongly in controls, and correlated with poorer social functioning (Global Functioning: Social), primarily in the psychosis group. Findings suggest that search for semantically related words may be impaired soon after psychosis onset. Future work is warranted to investigate the impact of language disturbances on social functioning over the course of psychotic illness.

Magnetoencephalography resting-state correlates of executive and language components of verbal fluency

Verbal fluency (VF) is a heterogeneous cognitive function that requires executive as well as language abilities. The purpose of this study was to elucidate the specificity of the resting state MEG correlates of the executive and language components. To this end, we administered a VF test, another verbal test (Vocabulary), and another executive test (Trail Making Test), and we recorded 5-min eyes-open resting-state MEG data in 28 healthy participants. We used source-reconstructed spectral power estimates to compute correlation/anticorrelation MEG clusters with the performance at each test, as well as with the advantage in performance between tests, across individuals using cluster-level statistics in the standard frequency bands. By obtaining conjunction clusters between verbal fluency scores and factor loading obtained for verbal fluency and each of the two other tests, we showed a core of slow clusters (delta to beta) localized in the right hemisphere, in adjacent parts of the premotor, pre-central and post-central cortex in the mid-lateral regions related to executive monitoring. We also found slow parietal clusters bilaterally and a cluster in the gamma 2 and 3 bands in the left inferior frontal gyrus likely associated with phonological processing involved in verbal fluency.

Abnormal global-brain functional connectivity and its relationship with cognitive deficits in drug-naive first-episode adolescent-onset schizophrenia.

Abnormal functional connectivity (FC) has been reported in drug-naive first-episode adolescent-onset schizophrenia (AOS) with inconsistent results due to differently selected regions of interest. The voxel-wise global-brain functional connectivity (GFC) analysis can help explore abnormal FC in an unbiased way in AOS. A total of 48 drug-naive first-episode AOS as well as 31 sex-, age- and education-matched healthy controls were collected. Data were subjected to GFC, correlation analysis and support vector machine analyses. Compared with healthy controls, the AOS group exhibited increased GFC in the right middle frontal gyrus (MFG), and decreased GFC in the right inferior temporal gyrus, left superior temporal gyrus (STG)/precentral gyrus/postcentral gyrus, right posterior cingulate cortex /precuneus and bilateral cuneus. After the Benjamini-Hochberg correction, significantly negative correlations between GFC in the bilateral cuneus and Trail-Making Test: Part A (TMT-A) scores (r=-0.285, p=0.049), between GFC in the left STG/precentral gyrus/postcentral gyrus and TMT-A scores (r=-0.384, p=0.007), and between GFC in the right MFG and the fluency scores (r=-0.335, p=0.020) in the patients. GFC in the left STG/precentral gyrus/postcentral gyrus has a satisfactory accuracy (up to 86.08%) in classifying patients from controls. AOS shows abnormal GFC in the brain areas of multiple networks, which bears cognitive significance. These findings suggest potential abnormalities in processing self-monitoring and sensory prediction, which further elucidate the pathophysiology of AOS.

Motor restrictions impair divergent thinking during walking and during sitting

Creativity, specifically divergent thinking, has been shown to benefit from unrestrained walking. Despite these findings, it is not clear if it is the lack of restriction that leads to the improvement. Our goal was to explore the effects of motor restrictions on divergent thinking for different movement states. In addition, we assessed whether spontaneous eye blinks, which are linked to motor execution, also predict performance. In experiment 1, we compared the performance in Guilford’s alternate uses task (AUT) during walking vs. sitting, and analysed eye blink rates during both conditions. We found that AUT scores were higher during walking than sitting. Albeit eye blinks differed significantly between movement conditions (walking vs. sitting) and task phase (baseline vs. thinking vs. responding), they did not correlate with task performance. In experiment 2 and 3, participants either walked freely or in a restricted path, or sat freely or fixated on a screen. When the factor restriction was explicitly modulated, the effect of walking was reduced, while restriction showed a significant influence on the fluency scores. Importantly, we found a significant correlation between the rate of eye blinks and creativity scores between subjects, depending on the restriction condition. Our study shows a movement state-independent effect of restriction on divergent thinking. In other words, similar to unrestrained walking, unrestrained sitting also improves divergent thinking. Importantly, we discuss a mechanistic explanation of the effect of restriction on divergent thinking based on the increased size of the focus of attention and the consequent bias towards flexibility.

Segregated circuits for phonemic and semantic fluency: A novel patient-tailored disconnection study

Phonemic and semantic fluency are neuropsychological tests widely used to assess patients’ language and executive abilities and are highly sensitive tests in detecting language deficits in glioma patients. However, the networks that are involved in these tasks could be distinct and suggesting either a frontal (phonemic) or temporal (semantic) involvement.42 right-handed patients (26 male, mean age = 52.5 years, SD=±13.3) were included in this retrospective study. Patients underwent awake (54.8%) or asleep (45.2%) surgery for low-grade (16.7%) or high-grade-glioma (83.3%) in the frontal (64.3%) or temporal lobe (35.7%) of the left (50%) or right (50%) hemisphere. Pre-operative tractography was reconstructed for each patient, with segmentation of the inferior fronto-occipital fasciculus (IFOF), arcuate fasciculus (AF), uncinate fasciculus (UF), inferior longitudinal fasciculus (ILF), third branch of the superior longitudinal fasciculus (SLF-III), frontal aslant tract (FAT), and cortico-spinal tract (CST). Post-operative percentage of damage and disconnection of each tract, based on the patients’ surgical cavities, were correlated with verbal fluencies scores at one week and one month after surgery. Analyses of differences between fluency scores at these timepoints (before surgery, one week and one month after surgery) were performed; lesion-symptom mapping was used to identify the correlation between cortical areas and post-operative scores.Immediately after surgery, a transient impairment of verbal fluency was observed, that improved within a month. Left hemisphere lesions were related to a worse verbal fluency performance, being a damage to the left superior frontal or temporal gyri associated with phonemic or semantic fluency deficit, respectively. At a subcortical level, disconnection analyses revealed that fluency scores were associated to the involvement of the left FAT and the left frontal part of the IFOF for phonemic fluency, and the association was still present one month after surgery. For semantic fluency, the correlation between post-surgery performance emerged for the left AF, UF, ILF and the temporal part of the IFOF, but disappeared at the follow-up.This approach based on the patients’ pre-operative tractography, allowed to trace for the first time a dissociation between white matter pathways integrity and verbal fluency after surgery for glioma resection. Our results confirm the involvement of a frontal anterior pathway for phonemic fluency and a ventral temporal pathway for semantic fluency. Finally, our longitudinal results suggest that the frontal executive pathway requires a longer interval to recover compared to the semantic one.

INTERLEUKIN-6 AND C-REACTIVE PROTEIN AS INDICATORS OF LATE-LIFE COGNITIVE DECLINE IN DEMENTIA

Background: Patients with dementia have higher levels of peripheral inflammatory markers. We investigated whether midlife levels of interleukin-6 (IL-6) and C-reactive protein (CRP) predicted concurrently evaluated intelligence and eventual cognitive impairment in order to determine their causal function. Method: In the cohort study, the mean values of IL-6 and CRP were measured in 100 individuals taking irregular supplements of vitamins (27.8% of whom were women) between Oct 2019 and May 2020 and June 2020 and Oct 2020. These values were then divided into tertiles to examine a 1-year decline in the mean (mean = 1, SD = 2) standardised scores of verbal fluency, memory, and reasoning. Logistic regression was used to model declines greater than 2 points. For the baseline age, sex, and education, as well as for subsequent analyses, adjustments were made to the analyses. Result: In cross-sectional research, participants with high IL-6 levels had poorer reasoning scores (0.08 SD; 95% [CI] 20.13, 20.02). In a retrospective study, participants with high IL-6 had a 1-year reduction in reasoning that was larger (p-value = 0.02) than that of those with low IL-6 (20.28; 90% CI 20.30, 20.26) (20.34; 90% CI 20.36, 20.32). In none of the tests, CRP was connected to deterioration. Conclusion: The overall cross-sectional and long term impacts across the 1-year observation time approximated to an age effect of 2.5 months; elevated IL-6 but not CRP in midlife indicates cognitive deterioration.

Verbal fluency response times predict incident cognitive impairment.

IntroductionIn recent decades, researchers have defined novel methods for scoring verbal fluency tasks. In this work, we evaluate novel scores based on speed of word responses.MethodsWe transcribed verbal fluency recordings from 641 cases of incident cognitive impairment (ICI) and matched controls, all participants in a large national epidemiological study. Timing measurements of utterances were used to calculate a speed score for each recording. Traditional raw and speed scores were entered into Cox proportional hazards (CPH) regression models predicting time to ICI.ResultsConcordance of the CPH model with speed scores was 0.599, an improvement of 3.4% over a model with only raw scores and demographics. Scores with significant effects included animals raw and speed scores, and letter F speed score.DiscussionNovel verbal fluency scores based on response times could enable use of remotely administered fluency tasks for early detection of cognitive decline.Highlights The current work evaluates prognostication with verbal fluency speed scores. These speed scores improve survival models predicting cognitive decline. Cases with progressive decline have some characteristics suggestive of Alzheimer's disease. The subset of acute decliners is probably pathologically heterogeneous.

Abstract- Poster

INTRODUCTION.§ Frontotemporal dementia (FTD) refers to a group of dementias characterized by degeneration in the frontal and temporal lobes of the brain. Rates of early-onset FTD are high with 13% of individuals with FTD being under the age of 50.§ Younger cases of FTD tend to exhibit frequent abrupt mood changes, increased aggression, behavioral disinhibition, lack of empathy, and deficits in working memory.There are three clinical presentations of FTD: behavioral variant (bvFTD) and two forms of primary progressive aphasia.Here we report a a 37 yr Old married man was brought with complaints of a progressive history of changes in behaviour and personality.The patient was in good baseline health until age 35 years, when his family noticed an increase in change in behavior with history of cannabis smoking for 2 yrs, H/O multiple extra marital affairs for 2 yrs,with H/O restlessness,dull and withdrawn, sleep disturbance,poor self care, refusing to eat properly, slowly not speaking to anyone, poor work performance for the past 6 months. He was diagnosed as a case of substance induced psychosis with catatonic features and treated. Again after three months pt presented to psychiatric opd with complaints of restlessness, speech difficulty forgetting things, inappropriate laugh,disinterest in daily activities, walking in the house all the time, disinhibited behaviour,weight loss,excessive craving for tobacco,putting inedible things at mouth all these symptoms for one month.On Mse O/E he was alert,ambulant,kempt,yawning frequently during interview, not cooperative, sits in chair and gets up frequently, no Spontaneous speech. He did not attempt to initiate conversation, answering questions with short, terse responses. relevant replies. He often gazed with a prolonged, fixed stare and exhibited motor stereotypies such as clapping his thighs or tapping his feet vigorously.— There were no upper or lower motor neurone signs, frontal release signs positive, and no parkinsonism or limb apraxia. His gait was normal. He scored only 55 out of 100 on the Addenbrooke’s Cognitive Examination-III, with impairments across domains but with particularly poor executive function (naming only two words beginning with P in a minute, and only 10 animals over a minute, leading to a very low verbal fluency score of 4 out of 14). Attention (score 12 out of 18), language (19 out of 26), memory (9 out of 26) and visuospatial (11 out of 16) abilities were also affected.— Further neuropsychological testing identified a global reduction in general intellectual function, with severe executive function deficits as well as poor verbal working— Neurology opinion obtained as a case of young onset FTD— MRI scan of the brain showed substantial bilateral, symmetrical frontal atrophy, with no evidence of white matter changes that would be typical of a vascular, vasculitic or inflammatory cause (figure 1). In addition, autoimmune encephalitis was negative; and HIV and syphilis serology were all normal or negative. Cerebrospinal fluid (CSF) contained no white cells or abnormal cells and therefore no evidence of an active inflammatory, infective or malignant process; the CSF protein concentration was also normal. PET scan suggestive of FTDReference 1. Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 2011;134:2456?77.2. Lebert F, Stekke W, Hasenbroekx C, et al. Frontotemporal dementia: a randomised, controlled trial with trazodone. Dement Geriatr Cogn Disord 2004;17:355?9.3. Warren JD, Rohrer JD, Rossor MN. Clinical review. Frontotemporal dementia. BMJ 2013;347:f4827.4. Neumann M, Mackenzie IRA. Review: Neuropathology of non-tau frontotemporal lobar degeneration. Neuropathol Appl Neurobiol 2019;45:19?40.5. Mann DMA, Snowden JS. Frontotemporal lobar degeneration: pathogenesis, pathology and pathways to phenotype. Brain Pathol 2017;27:723?36. Ct brain showed bilateral frontoparietotemporal Subdural HYGROMA.Neurologist opinion obtained. There was no focal neurological defecit and conservative management suggested. Patient was treated with tab risperidone 2mg 1-0-1 tab sodium valproate 200 mg 1-1-1, tab diazepam 5mg 0-0-1, her symptom improved with treatment (ymrs-12.)

Quality of life, mood and cognitive performance in older adults with cognitive impairment during the first wave of COVID 19 in Argentina

BackgroundIn Argentina, government has established lock down on 19 March in order to decrease SARS‐COV 2 infection. These restrictions have remained effective for long time, with increase of anxiety depression and insomnia as shown in several studies. Older population was particularly at risk due to greater limitations to go out. Our objective was to evaluate the impact of confinement in quality of life, mood and cognitive performance of older adults with cognitive impairment.MethodLongitudinal descriptive‐observational study. Patients with cognitive impairment (CDR 0.5‐1) attending to virtual cognitive stimulation sessions have participated. Participants have completed by themselves Quality of Life in Alzheimer's Disease scale (QOL AD), Beck Depression Inventory (BDI‐II), Test your Memory (TYM) and an attention and executive battery created by our institution. Same assessments were done at the beginning of the lock down and 7 months later. SPSS program was used and means, standard deviations and paired‐samples t test were calculated.Result51 adults (43 women, mean age: 68.53 SD: 8.06, mean education: 14.33 SD: 2.63) were included. An increase in BDI ‐II score (p = 0.049) and worse performance in one of the executive attention tests (p = 0.012) were found. No significant differences in total score of QOL‐AD (p = 0.090), TYM (p = 0.067), verbal fluency (p = 0.323) or memory tests (p = 0.098) were found. Reviewing sub items, differences in changes in sleep habits (p = 0.021), decrease in the energy level (p = 0.004), worse subjective record of memory capacity (p = 0.028) and decrease in ability to do housework (p = 0.007) were found. In those who lived alone a higher score in BDI ‐ II (p = 0.030) and TYM (p = 0.22) were found.ConclusionThis is the first longitudinal study that measures the impact of lockdown on quality of life and cognitive performance in older adults with cognitive impairment in Argentina. Lockdown and isolation have shown worsening of mood and some quality of life variables and decrease in attention. Finally, our results show an increase in depressive symptoms in those patients who lived alone.

When is more better? Modeling the effect of dose on the efficacy of the MAPT multidomain intervention as a function of individual characteristics

AbstractBackgroundDose is a critical factor examined in pharmacological treatment. However, little is known about the optimal dosage for non‐pharmacological multidomain interventions as well as the function that relates dose to improvement. These gaps have been assessed in this present study in interaction with individual characteristics, which may moderate the effect of dose. Magnification models predict that healthier individuals will benefit more from prolonged practice, whereas reserve models predict that training will reduce cognitive disadvantage.MethodThe data from the Multidomain Alzheimer Preventive Trial (MAPT) was used to determine the relationship between cognitive training dose and cognition, and its interaction with sex, age, education, entry criteria, CAIDE risk score, frailty and Apoe4 status. The MAPT is a three‐year randomized controlled trial, which includes cognitive training, physical activity, nutrition and omega‐3 polyunsaturated fatty acids in at‐risk individuals. The number of hours of cognitive training attended (max.=28) was used as a measure of dose in the 749 participants randomized to the multidomain intervention.ResultFirst, polynomial regression analysis modelled cognitive performance over time on memory, verbal fluency and composite cognitive score. Mixed model analyses measured the effect of dose on expected scores, and interaction with individual factors were assessed. A cubic function explained the relationship between dose and performance indicating benefits up to 12‐14 training hours followed by a plateau. Interactions were found with individual characteristics. Older participants and those with a higher CAIDE score reached their plateau more rapidly. Individuals with lower education and frail individuals benefited more from increased exposure.ConclusionA non‐linear dose‐response function indicates that more is not necessarily better. Here, the optimal dose was found to be 12‐14 hours of training, about half of what was potentially available to participants. A magnification effect is found for age and vascular risk factors as younger and healthier participants show larger benefit. However, a reserve effect is found in frail or less educated participants as they benefitted more from additional training experience than their more privileged counterparts.